Offering up-to-date, multidisciplinary coverage of this nuanced and evolving field, Cerebrospinal Fluid Rhinorrhea provides a comprehensive overview of the evaluation and diagnosis, as well as the medical and surgical management options, for all causes of cerebrospinal fluid (CSF) rhinorrhea. It covers all aspects of CSF leaks, synthesizing current knowledge on pathophysiology, diagnosis, perioperative care, and operative techniques for this complex group of patients. Leading experts in otolaryngology and neurosurgery, as well as ophthalmology, neurology, and radiology, provide detailed coverage of the distinctions between management of patients with differing etiologies of CSF rhinorrhea, including spontaneous, traumatic/iatrogenic, and tumor-related.

• Focuses exclusively on the comprehensive evaluation, and management of patients presenting with CSF leaks from the anterior cranial base, offering a reliable, one-stop resource for experienced clinicians as well as those in training.
• Covers the full breadth of cerebrospinal fluid rhinorrhea, with expert discussion of spontaneous CSF leaks, including evolving management techniques for patients with idiopathic intracranial hypertension; traumatic CSF leaks, including advanced management of complex anterior cranial base trauma; and up-to-date techniques for intraoperative skull base reconstruction after tumor resection.
• Includes tips and pearls on surgical approaches and postoperative management strategies for this complex and varied patient population.
• Features abundant high-definition images of anatomy, radiographic imaging, and intraoperative techniques, as well as videos that highlight intraoperative techniques in patients with spontaneous, traumatic, and tumor-related CSF leaks.
• Provides a detailed review of the different laboratory, examination (endoscopic nasal, as well as ophthalmologic) and imaging studies used to evaluate patients with CSF leaks.
• Discusses the evaluation and growing medical and procedural management options for patients with idiopathic intracranial hypertension.
• Offers state-of-the-art reconstruction options for CSF leaks and complex skull base defects, ranging from the nasoseptal flap and beyond.
• Addresses the controversial role of lumbar drains in CSF leak management, as will new and upcoming technological advances in operating room instrumentation.

Review

The most comprehensive and authoritative multidisciplinary reference on optimal CSF leak evaluation and management

Contents

۱. Categorizing cerebrospinal fluid leaks: A framework for understanding
۲. Evaluation of the patients with cerebrospinal fluid leaks: History and physical examination
۳. Confirmatory testing for cerebrospinal fluid rhinorrhea
۴. Role of imaging studies in the evaluation and localization of cerebrospinal fluid leaks
۵. Cerebrospinal fluid physiology and dynamics
۶. Surgical anatomy of the anterior cranial fossa
۷. Surgical anatomy of the middle cranial fossa
۸. Surgical anatomy of the posterior cranial fossa
۹. Pathophysiology and clinical evaluation of iatrogenic cerebrospinal fluid rhinorrhea after sinus surgery
۱۰. Pathophysiology and clinical evaluation of blunt force and penetrating trauma of the anterior cranial base
۱۱. Imaging of anterior skull base trauma
۱۲. Surgical management of iatrogenic cerebrospinal fluid rhinorrhea
۱۳. Surgical management of large traumatic anterior cranial base defects via craniotomy
۱۴. Postoperative management of traumatic cranial base defects
۱۵. Pathophysiology of spontaneous cerebrospinal fluid leaks and their relationship with idiopathic intracranial hypertension
۱۶. Diagnosis and medical management of idiopathic intracranial hypertension
۱۷. Surgical management of refractory idiopathic intracranial hypertension
۱۸. Ophthalmologic evaluation of idiopathic intracranial hypertension
۱۹. Radiologic findings in idiopathic intracranial hypertension
۲۰. Evaluation and management of congenital skull base defects
۲۱. Surgical management of spontaneous cerebrospinal fluid leak of the cribriform plate
۲۲. Surgical management of lateral sphenoid recess meningoencephaloceles and cerebrospinal fluid leaks
۲۳. Surgical management of spontaneous cerebrospinal fluid rhinorrhea arising from clival defects
۲۴. Postoperative management after cerebrospinal fluid leak repair in patients with idiopathic intracranial hypertension
۲۵. Clinical evaluation of the sellar mass patient
۲۶. Clinical evaluation of patients with skull base malignancies
۲۷. Radiologic evaluation of skull base masses
۲۸. Decision making in endoscopic skull base reconstruction: A graduated approach
۲۹. The nasoseptal flap: The workhorse for skull base reconstruction
۳۰. Locoregional pedicled flap options for skull base reconstruction
۳۱. Sellar reconstruction after pituitary adenoma resection
۳۲. Reconstruction after transtuberculum and transplanum approaches to suprasellar pathology
۳۳. Endoscopic reconstruction of anterior cranial fossa defects
۳۴. Endoscopic reconstruction of middle cranial fossa defects
۳۵. Endoscopic reconstruction of posterior cranial fossa defects
۳۶. Transorbital and transfrontal approaches to cerebrospinal fluid leak repair
۳۷. Free flap reconstruction of skull base defects
۳۸. Postoperative management after reconstruction following skull base tumor surgery
۳۹. Role of cerebrospinal fluid diversion in cerebrospinal fluid leak repairs and skull base surgery
۴۰. Advances in endoscopic visualization and surgical navigation
۴۱. Powered instrumentation and bipolar technology in endoscopic endonasal skull base surgery
۴۲. Evolution of synthetic graft materials and dural sealants for cerebrospinal fluid leak repair

Video Contents

Video 22.1. Modified transpterygoid approach for lateral sphenoid recess encephalocele.
Video 22.2. Transpterygoid approach: lateral recess of sphenoid.
Video 23.1. Endoscopic endonasal repair: spontaneous clival cerebrospinal fluid leak.
Video 29.1. Nasoseptal flap for skull base reconstruction.